Two weeks ago, on the cusp of February, Hannah, who had grown increasingly constipated in December and January, left her litter box empty. Still coping with the death of my mother, I became worried that this might be the start of the feline slippery-slope towards death (it was also the four year anniversary of Hannah’s life-threatening pancreatitis). I gave in to my PTSD-induced anxiety and brought her to the vet.

“Oh she has a heart murmur?” Dr. X said, after struggling to hold Hannah down on the exam table and placing the stethoscope to her chest. Dr. Parker, our regular vet, was out for a few days.

Hannah hid her face in my arms. “A heart murmur?” I repeated. What did this mean? I wasn’t sure if I trusted the opinion of this vet, who was a stranger to Hannah. I decided I would follow up with Dr. Parker after he returned.

In the meantime, I took the advice of my friend Stephanie and fed Hannah pure canned pumpkin, which she loved, and then I chased her around the garret (my own idea) until, finally, she went to the litter box and did her business. Unfortunately, three days later, she stopped loving the pumpkin and snubbed her nose at the tablespoon-full. Luckily, Dr. Parker had just returned. He recommended 1 teaspoon of Metamucil daily mixed in her wet food, and an echocardiogram for the heart murmur.

I bought a carton of Metamucil – the smallest I could find was itself the size of Hannah (I think this will last us for more than nine lives). Struggling to make ends meet each month on a part-time teaching wage, I admit I debated whether or not to skip the echocardiogram, which cost a few hundred dollars. But, if Hannah had a heart condition, she could die if I were to leave it undiagnosed and untreated. So I went forward.

Two days later, I awoke earlier than usual to bring Hannah in for the echo. As I removed the carrier from its hiding spot next to the refrigerator, in reflexive reaction, Sam fled under the bed. Hannah seemed relieved to have the living room to herself, finally. I picked her up, held her close to my chest, placing a towel over her paws to prevent her from straddling the top of the carrier (and thereby preventing entry), and lowered her in. When I opened the garret door to carry her out, she began to whine, and then her throat opened with crying meows that echoed and tore at my heart.

“I know, sweet girl,” I said. “You love living in this apartment much more than I do.”

“Hmmnh,” she responded as I turned the key to lock the door.

Sam refused to come out from under the bed, even for his favorite "cat dancer" toy.

I hated the idea of leaving Hannah at the clinic for the day, but that was the procedure. Drop off the cat at 7:30 a.m., pick up the cat in the late afternoon. The doctor would call when the results were ready. I left a plastic Ziplock bag of her duck and green pea kibble, in case she got hungry after the test: comfort food.

“This is the plan,” I talked to Hannah as I drove, my injured tailbone hurting without the donut pillow beneath it (in my anxiety I had forgotten it inside the garret). I knew she could not understand my words but I hoped my tone would somehow communicate to her that I was not giving her away. I was not giving her up. “I’m going to drop you off,” I began, “and you’re going to have this test so that we know what is wrong with your heart, and I’m going to go to work while you do that, and then, this afternoon, I’m going to come pick you up and take you back home, ok?” Hannah shuffled around the carrier as I spoke, meowing intermittently. “I love you, sweet girl.”

With my mother’s recent death on my mind, I wondered if this was the beginning of another end. I did not think I could tolerate losing my best feline friend, who had been with me through three apartments, four jobs, two brief relationships, and almost six years of PTSD recovery. She had been my one constant while my life fell apart and I worked to build it back up again.

In fact, it was not. Hannah’s Auntie Stephanie was here now, with new cousin Gabby-cat. Four years ago, I did not even know Stephanie. There was some comfort in having a familiar human – and her cat – present. It was, in some small sense, kind of like having family, which distracted me from feeling too much of the ache that spread across my chest and throat as I caught a glimpse of Hannah’s eyes, her gaze veiled with confusion, as the vet tech carried her away.

Seven hours later, Hannah was diagnosed with a heart condition labeled “dynamic right ventricular outflow tract obstruction” and “diastolic dysfunction significance unknown.” This was due to a benign cause, Dr. Parker said, however it could progress to heart disease quickly, or never in her lifetime. A blood panel would be a wise thing to do at this point, he added, to rule out any underlying disease in other organs that could be causing the murmur. The results showed that Hannah’s liver enzymes were elevated, which indicated inflammation, and her thyroid level was borderline. Testing for hyperthyroidism would be prudent. I agreed to this, despite the accruing bill, because knowing the answers could save Hannah’s life.

“She was very cuddly the whole time,” the vet tech said when she brought Hannah to me.

When I brought Hannah home, and opened the carrier door, she galloped around the garret, from room to room, checking to see if everything was still in its place – the living room, the water bowl, the mouse toys, and Sam – Sam looked at his big sister but he stayed under the bed. Not even his favorite “dancer” toy could lure him out. When he did finally emerge, he remained very quiet, refraining from his usual somersaulting over mouse toys and throwing his body off high ledges. He approached Hannah delicately, sniffed her tail, and made a face as if to say “ewww, you stink!” and backed away. To a cat’s nose, Hannah smelled foreign, like the clinic. She spent the next hour giving herself a bath and chewing off a patch of skin on her hind leg where her blood pressure was taken.

That night, Hannah cried, waking me. I turned on the light: 3:30 a.m. I got out of bed and followed the sound, found her sitting in the middle of the living room floor. She let out long mournful cries every few minutes. What she in pain? I wondered. Hungry? She hadn’t cried this way since the day I adopted her. I ran my palm across her back, and she pushed her head into my hand. I sprinkled some kibble in front of her, which she gobbled up quickly. Sam sat a few feet away, looking anxious. I gave him a pat, then got back into bed. The crying went on intermittently for the rest of the night, and nothing I did made it stop. I came to the conclusion Hannah was distressed from her day and needed to get it out of her system. Crying was her release, her way of returning to herself again.

Three days later, hyperthyroidism was ruled out and Hannah was placed on a prescription of feline SAMe to bring down the liver enzyme count. Dr. Parker asked if I could “pill” Hannah. I reminded him that it took two vet techs to hold Hannah down to pill her when she was deathly ill four years before – and even then she spit out the pill. She was a fighter. Dr. Parker said SAMe had to be taken on a empty stomach but using a pill pocket would be okay. I was skeptical about whether or not Hannah would be tricked by a pill pocket; while SAMe had her little b(r)other’s name in it, it was known for having a bitter taste, one I was sure Hannah would detect upon licking. I imagined she would eat all around the pill and leave its tiny pink face glistening on the floor.

When I opened the package of duck-flavored hypoallergenic pill pockets, Hannah arrived at my feet, sat, and looked up at me expectantly. She wanted the pill pocket. Quickly, I stuffed SAMe within the malleable “treat,” and placed it on the floor. In her usual cautious manner, Hannah first sniffed, then sampled a brief taste, then ate the rest, pill included.

“Good girl!” I praised her and repeated, hoping she would not spit out the pill. “Good girl.”

Having ingested her medicine, she walked away happily to perch on the back garret window and sun herself. Twenty minutes later, however, she vomited up the pill pocket, and the pill. So I took out another pill pocket and placed the (undigested) pill inside, and fed it to her again. This time, thankfully, she kept it down.

Soon, Sam caught on and wanted a pill pocket too. However the package only had 40-count and with 30 days of pills for Hannah, anticipating having to do it twice should there be vomiting, I could not afford to give out free samples. So I bought Sam a new toy: a large mouse stuffed with catnip. I tossed it on the floor and he went for it as if it were prey. He held the toy mouse in his mouth, sat and growled, then scared himself with his own growling and ran into the bedroom, where he kept the mouse beside him as he watched the traffic go by the window. Later, he buried it in the water bowl in the hallway.

Last night, as I sat down for the first time to relax after the long week, Hannah and Sam began to play a game of “cat hunt.” All of a sudden there was a blur of orange tabby and calico cat rolling on the floor in a ball, Sam on the bottom, his mouth open, Hannah towering over him (even though he stands an inch taller than she), pounding him with her paws…more tussling…then a scream (I’m still uncertain if it was Sam or Hannah), and then both were on all fours with Hannah blowing a tremendous hiss in Sam’s face. Sam’s eyes watered from the play-fight. He blinked and licked his lips and began to caterwaul with a baby voice. Hannah stood her ground as the alpha and hissed again, inching her body forward, putting her paw in the air as if to say “don’t make me hit you.” Finally, Sam backed off and, a moment later, all was calm.

{Postscript: Just after posting this blog entry today, Hannah refused to ingest her SAMe pill. She ate all of the pill pocket around it, then left the pink pill. I tried again. No luck. I’m going to wait an hour and try again. I welcome any and all suggestions, readers….Post-Postscript: Ok, two hours and four pill pockets later, I shut Sam in my bedroom and gave Hannah some extra-special brushing by her favorite window seat, and then offered up the pill. She ate it, finally. Now let’s hope she keeps it down!}

– TLS

How do you deal with a sick pet? Share your stories in the comment box below!

My essay, “Writing Taboo: Speaking the Unspeakable,” has just been published in the anthology Women on Poetry: Writing, Revising, Publishing and Teaching, available at your local bookstore.